Nokea
Nurse Gray is tasked with caring for Mr. Thompson, a client with Parkinson's disease, and is focused on enhancing his nutritional intake and ensuring safe swallowing. Considering the unique needs of Mr. Thompson, what interventions should Nurse Gray prioritize to facilitate effective swallowing and proper nutrition?
- A. Ensuring the client sits in an upright position while eating.
- B. Providing liquids during meals.
- C. Personally feeding the client.
- D. Encouraging the intake of solid foods.
Correct Answer: A
Rationale: Sitting in an upright position while eating helps prevent aspiration and facilitates safe swallowing in PD patients.
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The vagus nerve
- A. Arises from the medulla as a single nerve
- B. Receives nucleus ambiguous fibres from the accessory nerve
- C. Supplies motor fibres to the diaphragm
- D. Supplies sensory fibres to the facial region
Correct Answer: B
Rationale: The vagus nerve receives motor fibers from the nucleus ambiguus, which also contributes to the accessory nerve. It innervates muscles of the pharynx and larynx.
Dysphagia, dyphonia, dysarthria together with tongue atrophy & depressed "gag" reflex is called like following:
- A. bulbar palsy
- B. Bell's palsy
- C. pseudobulbar palsy
- D. bulbus olfactorius
Correct Answer: A
Rationale: Bulbar palsy is the correct answer because it results from damage to the lower motor neurons of the cranial nerves IX, X, and XII, which are located in the medulla oblongata. This condition leads to dysphagia, dysphonia, dysarthria, and tongue atrophy due to the loss of motor control in the muscles of the pharynx, larynx, and tongue.
When comparing a CVA and TIA, the nurse knows this is unique about TIAs:
- A. TIAs have permanent long-term focal deficits
- B. TIAs are intermittent with spontaneous resolution of the neurologic deficit
- C. TIAs are intermittent with permanent motor and sensory deficits
- D. TIAs have permanent long-term neurologic deficits
Correct Answer: B
Rationale: Transient ischemic attacks (TIAs) are characterized by temporary neurological deficits that resolve spontaneously within 24 hours. Unlike strokes, TIAs do not cause permanent damage but are warning signs of an increased risk for future strokes. Immediate evaluation and intervention are necessary to prevent a full-blown stroke.
If a patient displays a positive Babinski sign, the nurse should:
- A. Document the finding and consider further evaluation for neurological abnormalities.
- B. Ignore the finding as it is a normal response.
- C. Measure the patient's blood glucose levels.
- D. Assess the patient's skin color and temperature.
Correct Answer: A
Rationale: A positive Babinski sign in an adult indicates possible neurological dysfunction and requires documentation and further evaluation. Ignoring the finding or assessing unrelated parameters is inappropriate.
While the nurse performs formal patient assessment, assistive personnel often observe changes when obtaining vital signs or assisting patients with ADL's. When discussing care for a patient with back pain, the nurse should particularly alert the assistant to watch for:
- A. Dizziness
- B. Bowel/bladder incontinence
- C. Difficulty swallowing
- D. Arm weakness
Correct Answer: B
Rationale: Bowel and bladder incontinence in a patient with back pain may indicate cauda equina syndrome, a medical emergency caused by compression of the nerve roots in the lower spine. Dizziness, difficulty swallowing, and arm weakness are not typically associated with cauda equina syndrome.